P.N. Volotov, N.N. Volotov, A.V. Gulin

Introduction. The problem of chronic non-indemnified tonsillitis therapy and its complications is still acute because of high prevalence in all age groups, particularly with young people. However till now the possibilities of NO-therapy applications (immediate influence on the infection centre in palatine tonsils) in combination with intravenous laser irradiation of blood (treating blood with low intensive laser radiation) in chronic non-indemnified tonsillitis treatment are not studied enough. Purpose: to study the efficiency of NO-therapy applications in combination with intravenous laser irradiation of blood while treating the patients with chronic non-indemnified tonsillitis. Materials and methods. We had 104 men at the age of 18-22 suffering from chronic non-indemnified tonsillitis under the observation for 1 year. The patients of the control group (n=23) received standard treatment (antibacterial therapy with the account for microflora sensitivity, desensitizing therapy, daily lavage of palatine tonsils lacunas with antiseptic solutions, ultra-violet irradiation). The patients of main group I (n=29), beside the standard therapy after the sanation of pala-tine tonsils lacunas with antiseptic solutions had them "insufflated" with exogenous NO through a special attachment 1-2 times for 5-8 seconds. The course of treatment consisted of 7-10 proce-dures. The air-plasma stream was generated by "PLAZON" apparatus in NO-therapy regimen. The patients of main group II (n=24) in combination with standard therapy, for 7-10 days re-ceived intravenous laser irradiation of the blood with the light guide of unitary application through a patient-s ulnar vein. The radiation power of the light guide end face was 2.5 mW with 10 minute duration of the procedure. The low intensive laser radiation of the blood at red range was generated by "AZOR-VLOK" apparatus. The patients of main group III (n=28) in addition to standard treatment also received NO-therapy, and intravenous laser irradiation of blood according to the above-stated techniques. Clinical inspection of the patients included otorhinolaryngological survey (estimating the dy-namics of palatine tonsils hypertrophy reduction; a palatine tonsils and palatal handles mucosa hyperemia; regional lymph nodes sizes and morbidity) and disease catamnesis study. Palatine tonsils functional activity and their functional reserve were estimated by E.L. Popov and N.P. Pushchina's Method (Leningrad Ear, Throat, Nose and Speech Scientific Research Insti-tute, 1987) prior to the beginning, in 6 months and 12 months time on termination of the treat-ment. Results. Changes of palatine tonsils and regional lymph nodes in all the groups of patients with chronic non-indemnified tonsillitis met with identical frequency. After the treatment their frequency has significantly decreased with whose patients who received low intensive laser radia-tion influence alongside with standard treatment. During the period of observation the greatest clinical effect is noted with main group III. In the control group recurred paratonsillar abscesses were observed with 15 patients (65%). One patient developed reactive polyarthritis, one of the patients suffered transferred rheumatic disease attack. Bilateral tonsilectomy is executed to nine patients (39%). In main group I there were 5 cases (17%) of recurred a paratonsillar abscess, in main group II there occurred 3 cases (13%), and in main group I only 1 case (4%). No metatonsillar complications with the patients of the main groups were noted. Tonsilectomy wasn-t carried out with the patients of these groups. The lowest level of palatine tonsils functional activity and functional reserve were noted in all the groups of patients before the treatment. With the patients receiving standard therapy, they did not change during the period of observation. In main group I apart from standard treatment NO-therapy was applied, palatine tonsils functional activity and functional reserve did not show sig-nificant growth, and in a year returned to the initial level. Similar dynamics of palatine tonsils functional activity and functional reserve was seen with the patients suffering from chronic non-indemnified tonsillitis who received intravenous laser irradiation of blood in addition to standard treatment. Only with the patients of main group III whose treatment combined intravenous laser irradiation of blood and NO-therapy, a steady significant growth of palatine tonsils functional ac-tivity and functional reserve during the period of observation is noted. The reduction of average treatment duration by 2.3 days (р<0.05) on average was seen with the patients receiving standard treatment in combination with NO-therapy and intravenous laser irradiation of blood, confirms the efficiency of these physical methods in curing the patients with chronic non-indemnified tonsillitis. Conclusion: application of air-plasma streams in combination with intravenous laser irradia-tion of blood in complex therapy of chronic non-indemnified tonsillitis improves the efficiency of treatment, reduces its time and costs, it also reduces the risk to develop para- and metatonsillar complications.